Every year, seasonal influenza affects millions of people worldwide, leading to severe illness and numerous deaths. Despite these serious outcomes, many people do not see influenza as a serious illness due to its similar symptoms with the common cold. This misconception can lead to inadequate health-seeking behaviors and low uptake of preventive measures, such as vaccination and antiviral treatments. Furthermore, clinical trials on influenza are under development and might be introduced in Nepal in the near future. Enhancing participation in clinical trials is crucial for advancing influenza research and developing more effective treatments and preventions. There is a lack of literature in Nepali setting related to the perceptions of people towards influenza and thus to fill this existing gap, we propose a qualitative research that aims to explore how people perceive influenza and their health-seeking behavior in flu and flu-like illnesses. This study also aims to explore the factors that influence the willingness of people to participate in influenza related clinical trials.

This qualitative research will employ a grounded theory approach where a diverse population, aged 14 years and above of Kathmandu valley, will be purposively selected for one-to-one interviews and focus group discussions. Additionally, data collection will also include observation of health care settings like hospital OPDs and pharmacies to explore the health-seeking behavior of the study population. Data collection and analysis will be iteratively conducted until data saturation is achieved. All the interviews and discussions will be conducted in Nepali after a written consent is achieved from the study population, verbatim transcription of the recordings will be done that will be translated to English. An inductive thematic content analysis will be done by using Braun and Clarke’s six steps of analysis. The inductively generated codes will be categorized into similar patterns or themes in NVivo 14.0. To ensure trustworthiness of the study, data collection tools will be developed after a rigorous literature review and in collaboration with the researchers working in influenza. Necessary changes in the guides will be made after pre-testing the guides with pilot interviews. Similarly, the interviewers will be trained for taking interviews and facilitating group discussions and will be mindful of their positionality during the data collection and analysis.The findings from the proposed study is expected to provide valuable insights into community perceptions on influenza, their health-seeking behaviors during flu-like illnesses, and the influencing factors to participate in clinical trials in the Kathmandu Valley. Understanding these aspects will contribute to provide a basis for planning strategies for community engagement to support the existing influenza related research and future influenza-related clinical trials.